Submuscular Placement of Baclofen Infusion Pumps: Case Series and Technique.

Annals of Plastic Surgery
Jarrod T BogueDavid M Otterburn

Abstract

Baclofen pumps provide treatment of symptoms of spasticity for disease processes such as cerebral palsy and traumatic brain injury. These devices provide continuous infusion or periodic dosing of intrathecal baclofen (ITB). Traditionally, these pumps have been placed subcutaneously. Subcutaneous device placement has been associated with infection and extrusion. Baclofen pumps are large and range from 8 to 10 cm in diameter and 4 to 8 cm in width. Patients requiring device placement typically have a paucity of subcutaneous tissue. Cachexia coupled with the size and bulk of these devices leads to increased protusion and friction. Submuscular placement provides a well-vascularized pocket that directs the device inward eliminating protrusion and decreasing the potential for soft tissue breakdown. A retrospective chart review of ITB pump placement in a submuscular plane by a single plastic surgeon at a major academic center in conjunction with a neurosurgeon was performed. Inclusion criteria were cases of primary placement or replacement of ITB pumps and spasticity requiring ITB. Major complications included infection, extrusion, and reoperation. Five patients during a 5-month period were treated with submuscular placement of ITB pu...Continue Reading

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Citations

Jul 16, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ajay PatelJeffrey S Raskin

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